Background Leptospirosis, caused by the Leptospira bacteria, is an acute infectious disease that is mainly transmitted by exposure to contaminated soil or water, thereby presenting a wide range of subsequent clinical conditions. This study aimed to assess the distribution of cases and deaths from leptospirosis and its association with social vulnerability in the state of Rio Grande do Sul, Brazil, between 2010 and 2019. Methods The lethality rates and incidence of leptospirosis and their association with gender, age, education, and skin color were analyzed using chi-square tests. The spatial relationship between the environmental determinants, social vulnerability, and the incidence rate of leptospirosis in the different municipalities of Rio Grande do Sul was analyzed through spatial regression analysis. Results During the study period, a total of 4,760 cases of leptospirosis, along with 238 deaths, were confirmed. The mean incidence rate was 4.06 cases/100,000 inhabitants, while the mean fatality rate was 5%. Although the entire population was susceptible, white-colored individuals, males, people of the working-age group, along with less-educated individuals, were more affected by the disease. Lethality was higher in people with dark skin, and the prime risk factor associated with death was the direct contact of the patients with rodents, sewage, and garbage. The social vulnerability was positively associated with the incidence of leptospirosis in the Rio Grande do Sul, especially in municipalities located in the center of the state. Conclusions It is evident that the incidence of the disease is significantly related to the vulnerability of the population. The use of the health vulnerability index showed great relevance in the evaluation of leptospirosis cases and can be used further as a tool to help municipalities identify disease-prone areas for intervention and resource allocation.
Although leptospirosis is endemic in most Brazilian regions, South Brazil shows the highest morbidity and mortality rates in the country. The present study aimed to analyze the spatial and temporal dynamics of leptospirosis cases in South Brazil to identify the temporal trends and high-risk areas for transmission and to propose a model to predict the disease incidence. An ecological study of leptospirosis cases in the 497 municipalities of the state of Rio Grande do Sul, Brazil, was conducted from 2007 to 2019. The spatial distribution of disease incidence in southern Rio Grande do Sul municipalities was evaluated, and a high incidence of the disease was identified using the hotspot density technique. The trend of leptospirosis over the study period was evaluated by time series analyses using a generalized additive model and a seasonal autoregressive integrated moving average model to predict its future incidence. The highest incidence was recorded in the Centro Oriental Rio Grandense and metropolitan of Porto Alegre mesoregions, which were also identified as clusters with a high incidence and high risk of contagion. The analysis of the incidence temporal series identified peaks in the years 2011, 2014, and 2019. The SARIMA model predicted a decline in incidence in the first half of 2020, followed by an increase in the second half. Thus, the developed model proved to be adequate for predicting leptospirosis incidence and can be used as a tool for epidemiological analyses and healthcare services.Temporal and spatial clustering of leptospirosis cases highlights the demand for intersectorial surveillance and community control policies, with a focus on reducing the disparity among municipalities in Brazil.
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